Effective January 1, 2014 employees will see changes in their 2014 health insurance plan. Faced with rising health care costs, City staff and labor representatives on the Benefits Labor Management Committee worked together to develop a solution that keeps monthly premium changes to a minimum. Without this action, employees would have faced monthly premiums in 2014 that are one-and-a-half times higher than the premiums they are paying this year. To avoid a premium increase that would have impacted all employees, changes have been made to the deductible and out-of-pocket maximum.

The 2014 deductible will increase:

The deductible is the amount that you pay for covered services each calendar year before your health insurance begins to make payments for claims. (Deductibles do not apply to preventive services such as routine physicals and eye exams; these are fully covered.)

The deductible in 2014 will increase:

From $1,000 to $2,000 for an individual.

From $2,000 to $4,000 for a family.

The 2014 out-of-pocket maximum will increase:

The out-of-pocket maximum is the most you have to pay for covered services for deductibles, copayments and coinsurance each calendar year. Typically only about 10 percent of City employees reach the out-of-pocket maximum in a given year.

The out-of-pocket maximum in 2014 will increase:

From $2,000 to $3,000 for an individual.

From $4,000 to $6,000 for a family.

Additional changes effective January 1, 2014 include:

The employer-paid life insurance death benefit will increase from $10,000 to one times the employee’s salary, up to a maximum of $50,000.

Preventive health care received by out-of-network providers will no longer be covered at 100 percent. (Employees can still receive 100 percent preventive care coverage by using in-network providers.)

Double coverage for employees with spouses who work for the City has been eliminated. Each employee may take single health care coverage. If one spouse takes family coverage, the spouse is not eligible to sign up for additional coverage.

Employees who retire after Dec.31, 2013 and decline continued health care coverage will not be able to re-enroll in the City’s plan in a future year.

Monthly premium increase held to a minimum

Because the City’s health care claims have cost more than the premiums collected, a higher premium increase was initially proposed. The changes that are being made for 2014 enable the City to keep the premium increase to a minimum. The overall increase is now only 3.4 percent, as opposed to the 16.8 percent increase.

Elect and Essential networks

Employees who enroll in the Elect or Essential networks will see a slight decrease in their monthly premium contribution.

Choice network

Employees who enroll in the Choice network will see only a slight increase. Employees who are currently enrolled in the Choice network may want to consider changing to Elect or Essential for lower premium contribution rates. (In many cases, this may not require changing doctors or clinics.)

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